Friday, April 08, 2011

Oaklawn Information System “Goes Live with Cerner” this month

Patients may need patience during changeover.

With the hospital-wide conversion to a new computer system, patients may experience a slightly longer registration process and notice computer entry of medical information and notes taking a little longer. This conversion was dictated by the recent health care reform legislation as a means to improve patient safety and quality of service. It will also improve accessibility of records and data, and enhance efficiency in delivering services. Despite the initial high cost of installation, improved safety and efficiencies will reduce health care costs moving forward.
Three new questions have been added to registrations that ask one’s race, ethnicity, and preferred language. These questions are required for providers to receive full Medicare/Medicaid reimbursement. They are designed to help providers better understand the make-up of their customer base to improve communications and better meet their patients’ needs. They also assist health care studies by looking for trends among races as they relate to different ailments and disease. This information helps doctors know if patients are more at risk for certain disease and if they should be screened sooner than the norm.

What does “Go-Live with Cerner” mean to an Oaklawn Hospital employee? For most staff members, the “Live” is pronounced with the hard “i” as in “live broadcast,” and it means a massive hospital-wide conversion to a new clinical and administrative computer system is about to take place, converting everyone from the current system to one produced by a company called Cerner. To the nine members of Oaklawn’s Information Systems Department, however, “Go-Live with Cerner” uses the soft “i” pronunciation, because they have virtually been “living with Cerner” for over a year now, in preparation for this major shift.

The Center for Medicare and Medicaid Services (CMS) is the governmental department that sets and oversees the voluminous standards that health care providers must meet and adhere to in order to receive Medicare and Medicaid payments for patient services. The American Recovery and Reinvestment Act of 2009 established a CMS financial incentive program that provides stimulus funds to health care providers who implement or update electronic health record (EHR) technology in a meaningful manner. By making “meaningful use” of certified EHR technology, it is believed that providers will note a reduction in errors; have greater access and availability of records and data; and benefit from electronic safety reminders and alerts, improved clinical decision support, and more efficient and safe prescribing of drugs.

Natalie Spivak, Oaklawn’s Information Services Director, went through a similar conversion many year’s ago. “I wasn’t here when Oaklawn first implemented the Keane system,” Spivak said, “but I oversaw a similar process for a municipality and I said then I never want to do another one of these. But here I am,” she said with a smile, “and this one is much more complex than the other one I worked on.”

“It’s been a ton of work, but I’ve got a terrific team of colleagues that have committed themselves to making this a success and gone the extra mile to meet our deadlines and help get all departments converted and trained. And that team includes talented representatives from every department. This truly has been a hospital-wide effort that everyone’s on board with. It will take a few weeks for staff to get up to speed on the new format, but everyone knows this has been done to improve patient safety, quality of delivery, and to streamline and better coordinate interdepartmental services, and we’re excited to have a system that can do all that.”

Spivak said the hospital requested proposals from EHR system providers back in February of 2009, and after reviewing a number of proposals signed a contract with Cerner in December. Plans then began taking shape for the official conversion campaign kickoff, which was March 22, 2010. “These systems are not nice neat programs that you can buy off the shelf at a Best Buy or Staples,” Spivak explained. They are more like system shells that each hospital has to have customized to their departments and processes. Our consultants had to sit down with us to learn our goals and procedures so that they can design a system that met our needs and included all the customary safety checks and balances built in. We flew representatives from nearly every department, about 35 people, out to their home office in Kansas City to spend five intensive days with their consultants in order to design, build, and learn how to maintain the system. Some went three times.”

“We’ve also had to convert data from about 1.4 million patient visits from our old system into the new one so that the new system can access all our patients’ medical history. It has been an awesome and expensive undertaking, and a huge mountain to climb, but we’re near the mountain top and soon to reap the benefits.”

The “Cerner Go-Live” date is April 12, and patients and visitors will note special employees, called “Super Users,” dressed in royal blue tee shirts working side-by-side many care givers to assist with computer entries in this first week. “The data and information that our care givers will be entering is the same they’ve always used,” said Spivak, “but the format in which it is entered and the look of the screens will be much different, so it will likely take a little longer to enter data in the first several weeks.”

There are three stages of EHR technology incentives, with the first beginning in 2011 and 2012, and the last one in 2015. “We could’ve put this off a couple years,” said Spivak, “but there are greater financial incentives the earlier you start, and the whole point of this program is to improve patient safety and quality of care. That is what drives everything we do here, so there was never any question as to whether we attack this now or a couple years down the road. We jumped on it.”